Organization
MOUNTAIN VIEW DENTAL PDC PLLC
Active
Other names
Mountain View Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB WARNER (CREDENTIALING MANAGER)
(801) 691-1701
Entity
Organization
Contact information
Practice address
6783 S REDWOOD RD #201, SOUTH JORDAN, UT 84084-5743
(801) 969-8200
Mailing address
PO BOX 970057, OREM, UT 84097-0309
(801) 305-3460
(801) 335-6551
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223P0300X
Periodontics
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
11/12/2019
Last updated
12/15/2023
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